Any doctors on here? Mo Farah passed out at NYC Half - what could cause that? Or should I assume something sinister?

cbenson4 wrote:

Leave medicine to the pros wrote:

As an MD, it is threads like these that remind me just how:

A) Stupid the general populace is when it comes to medicine

and

B) How much the general populace thinks that they know

The guy who posted about the ED perspective is the only post worth reading.

You all are idiots.

Thank God you're not my doctor

Maybe he is. He posted anonymously. Unless you're a mod how do you know where he's from? How do you know where he works? Unless you know every doctor at your office well enough to know they don't browse LetsRun, he could very well be your doctor.

Ummm, did you forget that you took the Hippocratic Oath? Because it seems that in your case you took the Hypocritic Oath.

Leave medicine to the pros wrote:

As an MD, it is threads like these that remind me just how:

A) Stupid the general populace is when it comes to medicine

and

B) How much the general populace thinks that they know

The guy who posted about the ED perspective is the only post worth reading.

You all are idiots.

The guy who posted about the ED perspective is the only post worth reading.

You all are idiots.

What's the ED perspective?

And the idiots remark: well that's POD material. We are surrounded by idiots, including the purported doctor who made the remark.

Letsrun is a gift that keeps on giving! Love it. Embrace it.

Been working with high school athletes for almost a decade. Fainting happens. You see it a couple times a year, repeatedly in some athletes. Not once has any of these kids been diagnosed with a heart condition, and they all had follow-up examinations including EKG and stress tests.

A Dr. but not an MD wrote:

What's the ED perspective?

Cialis deficiency.

I am also a doctor. Without knowing any of the details of his vitals, and physical exam, everything is pure speculation. I strongly disagree that his collapsing was due to low blood pressure. The brain goes to great lengths to maintain normal perfusion pressure, and an elite athlete has a perfect circulatory system.

I have seen this happen enough times to say that the overwhelmingly most common cause is psychological. Athletes are exhausted at the end of a race and many times it takes an emotional toll beyond even the physical exhaustion, resulting in a shutdown of both the body as well as normal mentation. When this happens, the person usually bounces back very quickly, just like Mo.

If someone can produce a blood pressure, blood glucose, core body temperature or EKG strip showing an abnormality I will be very surprised.

They normally look like they have not even been jogging after the crossing the line. So what gets me is how you get from that to fainting

This is one of the dangers of microdosing, you take it all through training and then you deplete your body of essential medicines for the big day and subsequent drug test. The body just doesn't know how to cope without the drugs.

Leave medicine to the pros wrote:

As an MD, it is threads like these that remind me just how:

A) Stupid the general populace is when it comes to medicine

and

B) How much the general populace thinks that they know

The guy who posted about the ED perspective is the only post worth reading.

You all are idiots.

It is posts like this which remind me how arrogant and socially inept doctors in the United States tend to be.

Michele ferrari is concerned too

http://www.53x12.com/do/show?page=indepth.view&id=139

Universal Healthcare Please wrote:

Leave medicine to the pros wrote:

As an MD, it is threads like these that remind me just how:

A) Stupid the general populace is when it comes to medicine

and

B) How much the general populace thinks that they know

The guy who posted about the ED perspective is the only post worth reading.

You all are idiots.

It is posts like this which remind me how arrogant and socially inept doctors in the United States tend to be.

+1

Does the body really do a good job at maintaining cerebral flow in all circumstances?

Here's a study with much reference to this although in a somewhat different context.

http://stroke.ahajournals.org/content/39/2/336.full

Hypocapnia.

Well from the ED standpoint, he would have been worked up with a CT Brain, MR Brain, and CTA Chest with runoff to the toes, no? After all, you need to rule out pathology, correct?

Dude you forgot the CT neck. then we should also throw in a D-dimer, cardiac Echo to rule out second place finish induced takotsubo cardiomyopathy, tilt test, cardio consult, neuro consult, and it goes without saying if nothing comes back positive an admit to medicine for serial trops and an in house stress test ;)

Leave medicine to the pros wrote:

As an MD, it is threads like these that remind me just how:

A) Stupid the general populace is when it comes to medicine

and

B) How much the general populace thinks that they know

The guy who posted about the ED perspective is the only post worth reading.

You all are idiots.

Reading this thread reminds how much I hate doctor's with no people skills. When we go to a doctor, half of what I want is sympathy/compassion. I'm sick. Stop thinking you are so sick and listen to me. Be concerned. Explain things to me so I understand them.

-Rojo

PS. I generally just need you to prescribe me a pill i"ve googled on the Internet anyway. Either that or for you to tell me I have nothing really wrong and my body will fix itself. So it rarely matters if you are smart or not so get off your high horse.

Madmandoc wrote:

yes I am a doctor and a marathoner. It is very very worrisome that Mo passed out (medical term is syncope), but not due to any relation to PEDs.

But could it be a PED? What PED would cause you to faint,if any?

It could be so many different things it is truly not worth speculating. As someone who is very suspicious of salazar's group (I assume they are like lance before he was caught), I would bet this is not PED related, seriously. It just doesn't fit the picture.

That said, having an abnormally high hematocrit (red cells in your blood as a percentage of volume) can essentially block blood flow to vital organs responsible for being upright and conscious. If this happens in the heart it is known as a heart attack (or myocardial infarction). If this happens in the brain it is called an ichemic (meaning no blood) stroke. PEDS causing this are many. EPO, blood doping, procrit, lasix (secondary to relative dehydration), steroids are also well known to do this. These diseases are far more commonly caused by smoking, diabetes, age, etc.

Similarly, abnormal electrical firing of the nerves could cause this. In the brain, this is typically manifested seizure, extremely unlikely here. In the heart, this is an arrythmia (or atypical heart rhythm). PEDS here would be any diuretics (lasix, etc), any type of stimulant (cocaine, meth, adderall+ritalin, too much caffeine, epinephrine (aka adrenaline), thyroid hormone, much less likely asthma meds or anticholinergics). Much more likely this is due to dehydration, preexisting heart disease or childhood seizure disorders. Someone mentioned hypertrophic cardiomyopathy, I would bet Salazar's guys have heart Echos and maybe EKGs routinely and this would have been caught much earlier if he had it.

There are many many more possibilities here, most of them would be very unlikely to allow a runner to collapse but then run the rest of the race and get second place.

I would call this a syncopal episode, sounds like vasovagal/dehydration. WIki does a good job with the bare bones of the syncope causes, at least better than me.

http://en.wikipedia.org/wiki/Syncope_

(medicine)http://en.wikipedia.org/wiki/Syncope_(medicine)

Flat Stanley wrote:

http://www.telegraph.co.uk/sport/othersports/athletics/10701848/Mo-Farah-collapse-likely-to-have-been-due-to-low-pressure.html

Good article, written by: "Michael Davison, Sports Medicine Expert" and here's his qualifications:

Any chance of any of the other experts on here identifying themselves and their qualifications.